Thomas B Nordtvedt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

378 Issued in AK

Practice address

1621 Tongass Ave
Ste 103
Ketchikan, AK 99901

Phone

(907) 225-8228

Fax

(907) 225-8224

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thomas B. Nordtvedt, DDS, Apc

  • General Practice Dentistry
  • Ketchikan, AK
  • NPI 1952482572
  NPD (past) Authorized official
• Jason W. Evison, D.D.S., P.C.

  • General Practice Dentistry
  • Ketchikan, AK
  • NPI 1205147444
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063593671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 TONGASS AVE",
            "address_2": "STE 103",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-225-8228",
            "fax_number": "907-225-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 TONGASS AVE",
            "address_2": "STE 103",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-225-8228",
            "fax_number": "907-225-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDTVEDT",
        "first_name": "THOMAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000378",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Nickich
• Danielle Lynn Nickich
• Theresa F Nielsen, FNP
• Seong J Noh, M.D., PHD
• Lisa C Noland
• Northway Family Healthcare
• Maureen Northway, FNP-C
• Anthony Nunley
• Shannon Bridget O'Brien, M.D.
• Victoria L O'Brien

• General Practice Dentistry in Ketchikan, AK
• Providers in Ketchikan, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.